Beyond emergency surgery: redefining acute care surgery.

Background: Considerable debate exists regarding the definition, skill set, and training requirements for the new specialty of acute care surgery (ACS). We hypothesized that a patient subset could be identified that requires a level of care beyond general surgical training and justifies creation of this new specialty.

Materials And Methods: Reviewed patient admissions over 1-y to the only general surgical service at a level I trauma center-staffed by trauma and/or critical care trained physicians.

The "found down" patient: a diagnostic dilemma.

Background: "Found down" patients present to the emergency department (ED) after being discovered unconscious and are selected for trauma or medical evaluation based on ED triage. Occult injury is an important part of the differential diagnosis in these patients. Rational use of trauma resources and optimal care of these patients requires clear triage criteria and timely evaluation.